December 2001 MedBytes: Alzheimer's Disease

It's been 95 years since Dr. Alois Alzheimer first described the disease that bears his name. Today, nearly 4 million Americans -- including half of those over age 85 -- suffer from the memory loss, impaired judgment, and confusion that accompany Alzheimer's disease. The aging baby boom generation will explode those numbers in the next few decades, meanwhile adding millions of spouses, children, and friends to the ranks of the Alzheimer's caregivers. This month's issue of "MedBytes" provides links to Internet resources for physicians, their patients, their caregivers, and advocates for better research into and funding for the disorder. A special thanks goes to Robert Carroll, MD, of Nacogdoches, for his research and advice.

Alzheimer's Association One of the broadest Web sites on the topic is offered by the nonprofit Alzheimer's Association at www.alz.org. For physicians, it offers information on diagnosis, treatment, insurance coverage, and counseling caregivers. Similar comprehensive sections are aimed at patients and those who care for them. Researchers can download grant information and guidelines from the organization, which has donated more than $100 million to Alzheimer's research in the past two decades. The association lobbies for better research funding and improved Medicare coverage and long-term care for patients with the disease. Those who want to support these efforts can find concise tips and talking points for contacting their legislators -- and an online donation center.

Agency for Healthcare Research and Quality Early recognition and assessment of dementia, treatment when possible, and more time to plan the future of those diagnosed with Alzheimer's disease are the goals of the clinical guidelines posted by the Agency for Healthcare Research and Quality at www.ahcpr.gov/clinic/alzover.htm. The page includes links to the English and Spanish versions of a companion guide for the lay public.

Columbia University Predictors Study How much longer will your patient with Alzheimer's disease be able to live at home? How much longer will he or she live? At cpmcnet.columbia.edu/dept/sergievsky/predictor.html, the Columbia University College of Physicians and Surgeons provides an estimating tool based on research their team published in 1997 in the Journal of the American Medical Association. By entering some demographic and diagnostic information about a patient, the physician receives results such as: "Based upon the patients that we have followed, 25% of patients with a similar clinical profile require nursing home care within __ months, 50% within __ months, and 75% within __ months."

AlzheimersDisease.com Although it is clearly marked as coming from Novartis Pharmaceutical Corporation, the makers of Exelon, the Web site www.alzheimersdisease.com offers in-depth information on Alzheimer's pathophysiology and diagnosis for clinicians. Along with extensive material for the caregivers themselves, the site includes a checklist and other material to help physicians help caregivers deal with the stress Alzheimer's disease can place on family members and loved ones. The "Caregiver Corner" is designed as an all-purpose Internet portal with local weather, stock reports, disease information, and, of course, a pitch for the company's antidementia drug.

Alzheimer Research Forum Divided into three sections, the Alzheimer Research Forum's home page at www.alzforum.org is especially aimed at scientists investigating the causes and potential treatments of Alzheimer's disease. Its molecular genetics section, for example, includes a directory of genes that have been studied in relation to their role in the disease. A unique piece is the "Hypothesis Factory," an interactive forum "devoted to the presentation and exchange of ideas regarding novel hypotheses, hunches, theories-in-progress, etc." Patients and primary care physicians interested in research can check out the clinical trials directory at the National Institute on Aging site at www.alzheimers.org/trials.

MedBytes is a quick look at new, or newly discovered, Web sites of interest to Texas physicians. The column also highlights features of the TMA Web site at www.texmed.org. If you know of some cool medical sites or have questions about how to use the TMA Web site, email Erin Prather. Publication of information about Web sites in this column is not to be considered an endorsement or approval by the Texas Medical Association of the sites or sponsors, or of any products or services involved.